I stumbled across this while looking for something else. Interesting stuff. Don’t know if anyone has any better evidence for EPO-related deaths.

AbstractIn the wake of previous contributions by scholars like Verner Møller and Paul Dimeo, which have demonstrated the mythical nature of the accounts concerning two famous ‘doping deaths’ (the cyclists Arthur Linton and Knud Enemark Jensen), this article thoroughly examines the existing evidence (both anecdotal and scientific) concerning the much repeated claim that EPO ‘killed’ 18 Dutch and Belgian cyclists in the late 1980s and early 1990s. This examination shows that these claims almost absolutely lack empirical evidence, and that in fact the existing truly experimental and epidemiological research downplays or even rules out the existence of a casual link between EPO intake and sudden death in healthy adults. It is therefore concluded that EPO has been constructed by the expert literature and the lay press as the ‘drug of mass destruction’ of the war on drugs in sport, and that the story about the ‘EPO deaths’ is to be seen as anti-doping propaganda.

A search for journalistic texts reporting on these facts has been conducted using the LexisNexis database and accessing the online archives of some newspapers. Twenty-four news reports have been retrieved,35 in addition to a chapter from the journalistic book by Paul Kimmage. An analysis of these texts reveals an even higher degree of dispersion and imprecision. The number of victims range from ‘half a dozen’ to ‘around 40’ (other figures mentioned: 7, 14, 15, 16, 17, 18, 24 and 34). The most often quoted countries of origin are again Holland and Belgium, but Spain, Germany and Poland are also mentioned, with many texts simply referring to ‘European’ cyclists. And the time span can be as broad as 1970–1990, or as narrow as 1988–1990.

According to several sources, EPO began to circulate in Europe in 1987,48 when 3 of the victims recorded in Table 1 had already been retired for a long time. This reduces the number of potentially suspicious deaths to 14. The case of Bert Oosterbosch, who had retired in late 1988, the year before his death, should also be withdrawn from the list: if he had taken the drug during his professional career, its alleged deleterious effects would have faded long before his death.49 The list has now been reduced to 13. Four other victims died between October and February in the cycling off-season, when there was no point in charging up with such an expensive, cutting-edge drug.50 Of the remaining 9, 7 were amateur riders, who for the reasons just stated would be very unlikely consumers of the drug.51 This leaves the list with just 2 potentially suspicious riders: 1 low-profile young professional (only 23 when he died) and a cyclo-cross rider, neither of them the kind of usual suspect52 for such a hi-tech practice as EPO doping would have been at the time. These data therefore show little, if any, trace of the ‘about twenty world-class Dutch and Belgian cyclists’ killed by ‘rhEPO-induced erythrocytosis’.53 Of course, all this is not watertight scholarship, but at least it is based on some kind of empirical evidence and rational analysis. Perhaps the scientific literature can provide us with stronger counter-evidence concerning the claimed link between these deaths and EPO doping.

I have reviewed 35 academic texts referring to the alleged deleterious effects of EPO abuse: most of them are supportive of Eichner's contentions, in fact some of them citing Eichner himself as their original source.76 Of these articles/book chapters, 19 fail to provide empirical evidence or to quote any source for most or all of their claims concerning the fatal side-effects of EPO intake. Two of them77 just mention, as their only source, the statements or opinions, lacking empirical evidence, of anti-doping experts such as Eichner, Don Catlin and Robert O. Voy. Eight more articles refer some or all of their claims to other reports that either fail to quote a single source or piece of evidence, do not mention these side-effects, are based on literature reviews (not on original research) or quote some of the aforementioned experts. One article78 provides evidence for a sing le case of an elite cyclist in which thrombosis coincided with an intake of EPO and growth hormone. But the authors fail to provide proof of the causal link between the two, despite claiming that ‘the use of EPO to increase PCV [haematocrit] in athletes suffering from other predisposing factors to thrombosis … could lead to serious side effects’.79 So this leaves the list reduced to eight articles quoting original research and only six directly reporting original research conducted by the authors themselves, one of which is not based on actual experimentation but theoretical modellization.80

This article has shown that the story about the 18 Dutch and Belgian cyclists who allegedly died between 1987 and 1990 due to EPO abuse has no empirical basis. The available evidence rather suggests that this series of deaths has been artificially concocted and even inflated in absolute terms and, most importantly, that it is highly improbable that EPO had anything to do with these cases, principally because there is very little, if any, scientific evidence that EPO causes sudden death. It should therefore be considered more of a myth or an invention than a historical fact. A myth which in the last years has played a central role in the ‘scaremongering tactics’111 of the anti-doping campaigners, who until the early 1990s were rather short of casualties that might be attributed to doping ‘abuse’. In this sense, EPO could be labelled as the drug of mass destruction in the war on doping.

The Father of Clean Cycling, Christophe Bassons wrote:When I look at cycling today, I get the impression that history is repeating itself: riders who are supposed to be rouleurs are climbing passes at the front of the race, and those who are supposed to be climbers are riding time trials at more than 50 kilometres per hour.

rhubroma wrote:What incentive did the UCI have, then, to establish a 50% hematocrit rule if it did not feel EPO was behind the death of those cyclists in the late 80's early 90's?

Rube, I read about your horrific accident on a bike. Hope for a speedy recovery, and don't be afraid to take the PEDs for this. Is there going to be a lawsuit involved?

To your question, I think much of the rationale was an attempt to level the playing field, reduce the potential advantage riders could gain (though ironically, when everyone started taking it, the field was probably less level, as riders with low HTs were favored).

They may have also believed the stories of EPO deaths. I did, they sounded quite plausible to me at the time. It's only recently, when I have read of people, and animals, with natural HTs in the 60s, that I have wondered if the viscosity argument was overblown.

These themes of things being massively exaggerated, taken out of context, and accepted as truth without any real argumentation even, are very common in cycling and anti doping discourse.

rhubroma wrote:What incentive did the UCI have, then, to establish a 50% hematocrit rule if it did not feel EPO was behind the death of those cyclists in the late 80's early 90's?

I read somewhere in here that the true initiative came from a doping Doctor (don't remember which one) just because by looking at the tendency of doping He was afraid that some deaths were going to happened in the future. People were pushing the limits by going well over 60%. Stories about the hematocrits of some riders going into the hospitals being over the roof. So I guess it was safety of the riders one of the main reasons.

rhubroma wrote:What incentive did the UCI have, then, to establish a 50% hematocrit rule if it did not feel EPO was behind the death of those cyclists in the late 80's early 90's?

I recall reading of Dutch under-23 heart attacks with not a peep from the UCI. As in, suddenly, for the first time ever in the history of the sport, young riders are dying of heart attacks and the cycling federation did nothing. It just so happens Hein Verbruggen was President of the Road commission going onto President of the UCI.

Part of the problem with his data is there was no on busting out the autopsy investigation budget to figure it out. Not that it was a heart attack of some kind, but figuring out exactly *how* the heart attack came to be. Which, would be the equivalent of a needle in a haystack at the time.

Merckx index wrote:I stumbled across this while looking for something else. Interesting stuff. Don’t know if anyone has any better evidence for EPO-related deaths.

Here is the problem with your analysis. It focuses on whether or not EPO was the direct cause of the deaths of an unascertainable sample of cyclists. The ONLY way to know this is to obtain the autopsy reports of each and every rider for whom it is claimed or is suspected of dying due to the effects of EPO. Your "Abstract" does not even come close to dealing with this fundamental and seminal issue.

Secondly, you did no research and have not presented any research as to the effects of EPO on the blood and how it stresses the heart, both at rest and at play. Where are the cardiology research studies? We know that EPO increases the number of red blood cells, but what you fail to add to the discussion which is absolutely essential is those studies that describe the physiological effects of EPO on the blood and the heart.

Without this scientific data your post is interesting, but useless.

I have vision and the rest of the world wears bifocals
- Butch Cassidy

RobbieCanuck wrote:Here is the problem with your analysis. It focuses on whether or not EPO was the direct cause of the deaths of an unascertainable sample of cyclists. The ONLY way to know this is to obtain the autopsy reports of each and every rider for whom it is claimed or is suspected of dying due to the effects of EPO. Your "Abstract" does not even come close to dealing with this fundamental and seminal issue.

Secondly, you did no research and have not presented any research as to the effects of EPO on the blood and how it stresses the heart, both at rest and at play. Where are the cardiology research studies? We know that EPO increases the number of red blood cells, but what you fail to add to the discussion which is absolutely essential is those studies that describe the physiological effects of EPO on the blood and the heart.

Without this scientific data your post is interesting, but useless.

From memory EPO stimulates heart muscle growth, angiogenesis, but there were also studies on EPO effect on heart lesions (?) Very dim, distant memory.

RobbieCanuck wrote:Here is the problem with your analysis. It focuses on whether or not EPO was the direct cause of the deaths of an unascertainable sample of cyclists. The ONLY way to know this is to obtain the autopsy reports of each and every rider for whom it is claimed or is suspected of dying due to the effects of EPO. Your "Abstract" does not even come close to dealing with this fundamental and seminal issue.

Secondly, you did no research and have not presented any research as to the effects of EPO on the blood and how it stresses the heart, both at rest and at play. Where are the cardiology research studies? We know that EPO increases the number of red blood cells, but what you fail to add to the discussion which is absolutely essential is those studies that describe the physiological effects of EPO on the blood and the heart.

Without this scientific data your post is interesting, but useless.

1) this was not "my" research, and I didn't take a position on its validity

2) the author very explicitly pointed out the problem of not having access to autopsies. This doesn't mean he can't make any contribution to the problem. You work with what you have.

3) The author never concluded that EPO did not cause these deaths, at least in the end he concluded that the evidence that they didn't was (much) better than the evidence that they did. When people make a claim that something is the cause of death, the burden of proof is on them to show this, not on others to show that this is not the case. The author is not saying, "EPO was not the cause." He's saying, "you can't conclude that EPO was the cause." When in fact a large number of people, including scientists, have been concluding this, citing papers that contain no research of their own, this is a very important conclusion to make. I would definitely disagree that this conclusion is useless, it's very useful in showing how unsubstantiated conclusions get passed on to the point where almost everyone assumes they are supported by evidence.

4) He did cite studies of EPO on cardiac function. albeit only at 50% HT. He also cited one study reporting structural damage to the heart in mice with an elevated HT, but in addition to having a level far beyond that reported for any cyclist (80%!), this was a chronic condition, contrasting with cyclists, who do not take EPO all the time. I have seen other studies of animals with HTs in the 60s with no apparent adverse effects, though they may have naturally occurring adaptations that allow such levels chronically.

I think I understand your point, though. Some people, like these idiot fatty masters dopers, may read this article and say, hey, EPO is safe, I can jack up to 60%, and there will be no problems. And that would be unfortunate. From that point of view, you could argue that there is a greater burden of proof on those who say it probably didn't cause these deaths than those who insist it did. But if anti-doping officials really want to keep making this message, they ought to do studies to support it. It's not healthy to be promoting unsubstantiated claims, even if these claims are intended to protect people from themselves.

In any case, this guy is a historian. He's concerned not with getting some message out, but in understanding why a certain notion that is mostly unsupported came to be taken as gospel by so many. And as i said before, I think it's very useful to understand this.

There were certainly a number of Dutch and Belgian amateurs dying of heart attacks in the spring of 1990. It was the first time I had ever heard of EPO. If someone has some old editions of Winning from Feb/Mar/Apr 1990 I'm sure it was being reported there. The deaths were certainly news, whether the cause was definitively attributed to EPO I can't remember for certain. It was the impression I was left with though, scared me at the time in a wtf way.

Casado's case is mentioned above.Halupzcok also comes to mind.In the case of Draaijer, an autopsy was requested by his widow and soon after there was an article in L'Equipe where his wife, quoting the Doctor, said that Draijier's heart look like the heart of an old man (whatever that means).

It may well be that there's no evidence behind this story, but I disagree with some of the authors assumptions; for example a simple answer why an amateur, a cyclocrosser or a rider in the offseason might have been using EPO could have been to use them as lab-rats.

Or more generally: Just because the author doesn't think it makes sense for a specific athlete to have used EPO doesn't mean he wasn't using it.

Merckx index wrote:1) this was not "my" research, and I didn't take a position on its validity

2) the author very explicitly pointed out the problem of not having access to autopsies. This doesn't mean he can't make any contribution to the problem. You work with what you have.

3) The author never concluded that EPO did not cause these deaths, at least in the end he concluded that the evidence that they didn't was (much) better than the evidence that they did. When people make a claim that something is the cause of death, the burden of proof is on them to show this, not on others to show that this is not the case. The author is not saying, "EPO was not the cause." He's saying, "you can't conclude that EPO was the cause." When in fact a large number of people, including scientists, have been concluding this, citing papers that contain no research of their own, this is a very important conclusion to make. I would definitely disagree that this conclusion is useless, it's very useful in showing how unsubstantiated conclusions get passed on to the point where almost everyone assumes they are supported by evidence.

4) He did cite studies of EPO on cardiac function. albeit only at 50% HT. He also cited one study reporting structural damage to the heart in mice with an elevated HT, but in addition to having a level far beyond that reported for any cyclist (80%!), this was a chronic condition, contrasting with cyclists, who do not take EPO all the time. I have seen other studies of animals with HTs in the 60s with no apparent adverse effects, though they may have naturally occurring adaptations that allow such levels chronically.

I think I understand your point, though. Some people, like these idiot fatty masters dopers, may read this article and say, hey, EPO is safe, I can jack up to 60%, and there will be no problems. And that would be unfortunate. From that point of view, you could argue that there is a greater burden of proof on those who say it probably didn't cause these deaths than those who insist it did. But if anti-doping officials really want to keep making this message, they ought to do studies to support it. It's not healthy to be promoting unsubstantiated claims, even if these claims are intended to protect people from themselves.

In any case, this guy is a historian. He's concerned not with getting some message out, but in understanding why a certain notion that is mostly unsupported came to be taken as gospel by so many. And as i said before, I think it's very useful to understand this.